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Editors' Picks health care Interviews National

An Interview With POLITICO Healthcare Journalist Dan Diamond

Dan Diamond is a POLITICO policy reporter, the author of POLITICO’s Pulse newsletter, a daily briefing on the latest in healthcare, and the host of “Pulse Check,” a weekly podcast on which he hosts some of the biggest names in health care.

Before joining POLITICO in 2015, Diamond served as the Senior Director of News and Communications of The Advisory Board Company, a prominent health care consulting firm.

Diamond sat down with The Politic’s Molly Shapiro to talk about health care, his groundbreaking story on Tom Price, reporting on the Trump administration, and how Yale students can have an impact in the healthcare debate.

The Politic: Healthcare is a complex subject. Your readership is probably not all healthcare professionals. How do you reach an audience that might be, like me, not so informed when it comes to healthcare?

Dan Diamond: My goal is to have a daily column—a daily newsletter—that is useful for people inside the industry who are experts. It’s giving them something new, it’s driving that conversation forward. It’s also accessible enough that if a Yale student wanted to know the latest twist and turn in the Affordable Care Act fight, you’d be able to pick up and dive in pretty easily.

That’s tricky when there’s a lot of jargon. In an industry like health care, there’s a lot of failed legislative efforts that the average reader might not know about but a congressional staffer knows intimately, and it’s a hard balance to strike. Any story isn’t going to make every single reader happy; there are stories that someone who has been working in a field for 30 years says, “This is so basic and everybody knows this.” But for a lot of Americans, we don’t have time to focus on the intricacies of health care reform or nuclear power or the EPA. And it’s important to constantly be bringing fresh eyes to even what might seem like an old topic.

I think about that a lot in writing the newsletter and using moments to call up where we were and where we are. For example, there have been many moments when President Trump did something on health care on his 100th day, his 200th day, and it’s interesting to go back and compare that to what President Obama did on his 100th or 200th day. Obama led a town hall and took lots of health care questions; President Trump sent a few tweets. And I think it’s easy for someone like me to know because I’ve been covering this space for a while. But for many readers, they’ve kind of forgotten the arc of how the Obama presidency went in its first couple years, and I can be the connective tissue bringing them together.

You’ve said, “We have a president who does not think in policy.” How have you managed to cover both politics and policy? Can you describe the difference in covering the Obama administration and the Trump administration?

So let’s talk about the principals, then we’ll talk about the broader administration. President Obama and President Trump could not be further apart when it comes to policy matters. Obama was a policy wonk; he loved this stuff, he could teach this stuff. He knew more about the health insurance market than plenty of people who work in healthcare just because he had immersed himself in it, but on the flip side, that was sometimes his downfall. When he was asked to explain issues about health care, he’d give a long, professorial answer that maybe folks at Yale would like to hear, but a lot of average Americans felt like passed them by. President Trump is all bold colors—primary colors. And he doesn’t know the policy, and at times when he’s been pushed on what’s in his health care plan, he’s said the wrong thing. He’s been actively misleading. For him, it’s not about details, it’s about just getting a win. And that was never the Obama way. Obama sweated the details so much so that sometimes it was to the detriment of that White House which just wanted to get wins and Obama wanted things that were more perfectly-crafted.

The overall administration is different, too. Administrations take their cues from the president, the primary actor. When I was at POLITICO, I was talking to the Obama administration every day. I was talking to the White House Press Secretary, I was talking to HHS—the health care agency. In the last year of the Obama administration, they were accessible, whether that was because it was their last year, or whether it was because they just had been through the rhythms and the rigors, and they were more comfortable. Not that they were always happy—I would get yelled at Obama people sometimes mad about my stories—but at least I could talk to them and reach them.

The Trump administration has been very different. There was a story that Columbia Journalism Review did a few weeks ago where I’m quoted and we talk about this a bit, about not hearing back, asking simple questions like, “Does this administration still think that climate change has negative impacts on human health?” and getting no response. So we’ve gone from an administration that would write you back to an administration that has given reporters more of a cold shoulder.

You came to POLITICO from a health care agency, and you’ve said that you had to learn on the job. Can you describe the adjustment to reporting on Washington?

There were transferable skills when I got to POLITICO. I knew how to do analysis, I knew how to write, I understood health care. I didn’t understand how to work in the POLITICO news cycle. It’s one thing to write a piece for Vox and noodle over that and send it in and hope Ezra Klein or Sarah Kliff say it’s okay and it goes up on the website. It’s another thing to be in the news mix and to have a scoop and know how to move that scoop. And I probably shouldn’t admit this on record, but when I first started, I would get tips, and I wouldn’t really know how to turn them into things, and by the time I figured it out, the news cycle had moved on. So, some of it was learning the rhythm. Some of it was learning the people and the policy, and being a person who could navigate Capitol Hill and ask hard questions, which is very intimidating when you’ve never had that much face time with prominent lawmakers before. And all the sudden, now that person is in front of you and you’re expected to ask the direct question that gets a direct answer. So those were new skills and muscles that I had to learn.   

You and your colleague, Rachana Pradhan, were responsible for the reporting that led to Health and Human Services Secretary Tom Price’s resignation. Can you give the SparkNotes version of the Tom Price story?

Tom Price was tapped by Trump to be HHS secretary, so running Medicare, Medicaid, the Affordable Care Act, and also playing a pretty big role in repealing the Affordable Care Act. He was supposed to be Trump’s guy inside. Price had been a congressman for 12 years. He had been a major critic of the Affordable Care Act in Congress, an ally of Paul Ryan. He became HHS Secretary in early February.

A few months after he started, Rachana Pradhan got a tip that Tom Price, this critic of federal spending, was spending a lot on private jets—that everywhere he was traveling for work, he was getting a charter jet, which is unusual. Rachana tried to confirm it, couldn’t, brought it to me (our beats are a little different, so I focus more on HHS, that agency), and I quickly came to the same point that Rachana was—there was a lot of smoke about this, but no one would go on record to confirm it. And Price’s inner circle was so tight we couldn’t quite penetrate it.

Over the course of many months, we worked to compile whatever information we could about his trips, a task that was made harder because we only found out after he made the trip. That was a break in practice from the last administration. You’d find out three days later that Tom Price had been in Maine or in Ohio. And it was hard to know how he got there, who he met with. We built a database to try and make that clear. And we also kept working our sources, asking anyone who might be in the know about his travel. It came to a point where we had winnowed down that he was flying out of Dulles, one of the airports outside of DC, and we knew that he was flying to Philadelphia, leaving Friday, September 13. We staked out the airport, we saw Tom Price and Kellyanne Conway and the Secret Service as they did their round trip from Philadelphia, and that was enough evidence after months of trying. It gave us the hard proof to start asking questions about his travel, and we were steadily able to confirm more and more details about it. About two weeks later, he resigned.

Did you have any hesitation about going forward with this story, knowing that it would undoubtedly change, or perhaps even end, Tom Price’s career?

I thought about the impact, but not on Tom Price, but on HHS and on the taxpayer. The feeling of getting the first tip—of hearing that Price was flying charter jets, I knew it could be a big story because of his hypocrisy about federal spending and because it was such a break from tradition and all the other “drain the swamp” type stuff with the administration in the election. Did I ever stop and think that it would lead to his resignation? Maybe not until the last day. But it was a big story because it touched so many things and because it was one of the most prominent people in all of health care.

I don’t think we had any hesitation other than we had to get it right, and that’s why we never wrote a story until we could prove it. We had to make sure it was bulletproof. And we are proud, in POLITICO, that that reporting wasn’t challenged. The White House never came out and said, “This is fake news.” That’s unusual at this moment.

Can you tell us about a story that you’re proud of that has not gotten as much attention?

I wrote a long feature on the Cleveland Clinic, one of America’s great hospitals. It is a wonderful place to visit, it looks like an apple store—it’s white, glass, and there is music and Rothko on the walls. It’s absolutely lovely. But walk one or two blocks off campus, and you find run-down homes. At one point, I had just met with executives at the hospital and walked off-campus and met with a woman whose house had been broken into overnight and the door was hanging off its hinges.

It’s a dynamic that you see at Yale too. Yale New Haven Hospital, a powerful organization, with a lot of poverty around the hospital, and around Yale, too. My story about the Cleveland Clinic was a stand-in for some of the other challenges of powerful institutions that are tax-exempt. They’re not paying taxes because they are serving the community, but are they really? Healthcare folks have read that story, passed it around, but it’s more nuanced than some of the political stories I’ve done.

Your podcast, “Pulse Check,” has been called the “Charlie Rose of health care.” Can you talk about the aim of your podcast and how it differs from your print reporting?

What I want to do is shed light—it’s to bring attention to the policy issues that might not be as dramatic as colluding with Russia or not, but to explain why a Medicaid policy change is going to impact lots of Americans and hold the lawmakers who are making that change accountable. And I think the best way to do that is to at times ask direct questions, sometimes it’s to have more of the informal conversation that can produce insights, too. And that underpins all my reporting.

It’s easy to look at the health care debate and feel very powerless. How can we, as concerned citizens, have any impact or take any action that might make a difference?

I think there are two ways to think about that. There’s a lot of activism right now—advocacy, attending rallies, writing congressmen. Whether you think the Affordable Care Act is good, bad, or single payer is the way to go, there’s a lot of energy around that.

I also think there’s a very practical need for people to help one-to-one: To be a volunteer in an impoverished community, to work for a community health center and just get a sense of what it’s actually like on the frontlines. I would imagine that many Yale students don’t get exposed to that world. There’s a lot of poverty out there, and what happens in Washington doesn’t directly impact them. What they need is someone who’s going to make sure that they get routed to the right person in the health care system or an aide who will check in on them and make sure they’re taking the right medicine. Yale students may not be able to fill those roles. But they can help. They can help by working with a non-profit, starting their own, finding other volunteer opportunities, and I think there’s a big void on that end of the spectrum.